Provider Demographics
NPI:1679079776
Name:COOPER, STEVEN ALEXANDER (MS, PPS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:ALEXANDER
Last Name:COOPER
Suffix:
Gender:M
Credentials:MS, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 BROKEN BRANCH CT APT 160
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1816
Mailing Address - Country:US
Mailing Address - Phone:707-853-3117
Mailing Address - Fax:
Practice Address - Street 1:333 SUNRISE AVE STE 701
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3483
Practice Address - Country:US
Practice Address - Phone:916-783-5207
Practice Address - Fax:916-783-9145
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health